Kentuckians think cancer is biggest threat to adults, but heart disease kills more men in the state

Cancer is the leading health concern identified by Kentuckians, and is the principal cause of death among women in the state, though heart disease is the main killer of Kentucky men, the Kentucky Health Issues Poll found.

Thirty-six percent of Kentucky adults identified cancer as the most important health issue for men, followed by heart disease at 31 percent, according to a news release for the Foundation for a Healthy Kentucky, which co-funded the poll. Heart disease was the leading cause of death for Kentucky men in 2009, followed closely by cancer.

Only about 7 percent of Kentuckians identified obesity as the top health issue facing Kentucky adults, but 29 percent said it was the greatest concern for children, perhaps reflecting considerable public attention to concern about child obesity. "While childhood mortality is rare, there are lifelong health implications that can be linked to struggling with obesity and diabetes at an early age," the release said.

“Even though the results suggest some confusion about our biggest health threats, there are ways to reduce Kentucky’s chronic disease risks: eat healthy foods, exercise regularly, stop smoking or don’t start,” said Dr. Susan Zepeda, CEO of the foundation, which co-sponsored the poll with the Institute for Policy Research at the University of Cincinnati. The poll interviewed a random sample of 1,677 adults, 1,469 by landline phones and 208 via cell phones. In 95 of 100 cases, the estimates are accurate within a 2.4 percent margin of error. To see the report, click here.

Alternative medicine can help patients manage chronic pain

Patients can turn to health practices like meditation, massage, yoga and acupuncture rather than pills to help manage their chronic pain, says Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health.

"Much of health care involves helping people find solutions for tough problems like pain," Briggs said in a release distributed by research-reporting news service Newswise. "I think all physicians are well aware of how difficult it is to manage chronic pain patients. For example, with back pain we see that large numbers of patients are turning to these approaches with the hope of decreasing discomfort, improving function and quality of life, and minimizing side effects of pharmacologic treatments."

A nationwide survey released in 2008 found about 38 percent of U.S. adults ages 18 and over and about 12 percent of children use some form of complementary and alternative medicine. Back pain is the most condition for which treatment is sought. These types of therapies are even being used in military health care. New military guidelines released by the Office of the Army Surgeon General include some alternative modalities for treating pain. (Read more)

Losing just a little weight can reduce the risk of cancer

Losing even just a little weight — just 5 to 10 percent of total body mass — can help reduce the risk of getting common types of cancer, the National Cancer Institute has found. That's an important fact for Kentucky, which has high obesity and cancer rates.

Officials with the Office of the Surgeon General and the American Cancer Society say being overweight or obese can increase the risk of a wide variety of cancer, including prostate, kidney, colon, ovarian, cervical, thyroid, gall bladder and post-menopausal breast cancer.

"Fat cells produce estrogen, which promotes cell growth," reports Karina Christopher, a Lexington Herald-Leader contributor. "They also make a variety of proteins that cause inflammation and insulin resistance, which can promote cell growth and reproduction. People who tend to be 'apple-shaped' have even more fat activity, because fat cells around the middle of the body divide even more rapidly. The faster the cells divide, the higher the risk of developing cancer."

But losing just a small amount of weight by controlling food portions, getting active and planning meals ahead of time can help. (Read more)

Study finds new prostate-cancer test is better than current one

Researchers at the University of California at Los Angeles say they have developed a new test for prostate cancer that is "more sensitive and more specific" than the usual test for prostate-specific antigen, the UCLA Health System says in a news release on a new, peer-reviewed study.

"The conventional PSA test for prostate cancer has been used for nearly 30 years and is not specific enough in delineating between malignancies and non-malignant diseases of the prostate, such as benign prostatic hyperplasia (BPH), an enlarging of the prostate common in aging men that increases PSA levels," the release said, citing urology professor Gang Zeng, senior author of the study, published in the May issue of the Journal of Translational Medicine.

The new test "measures levels of PSA as well as six specific antibodies found in the blood of men with the disease," the release says. "The test, called the A+PSA assay, also reduced the rate of false-positives, tests that indicate the presence of cancer when no disease is actually present." For more from Newswise, click here.

Cavities can be contagious, researchers have found

A new study has found that cavities are contagious. "Just as a cold virus can be passed from one person to the next," so can cavity-causing bacteria that cling to teeth and eat food particles lodged on and between them, The New York Times' Anahan O'Connor reports.

Infants and children are especially susceptible, with bacteria often transmitted to them by their caregivers. One prime example is when mothers test food to confirm it's not too hot for a child. Couples can also spread the bacteria between each other. "In one instance, a patient in her 40s who had never had a cavity suddenly developed two cavities and was starting to get some gum disease," said Dr. Margaret Mitchell, a cosmetic dentist in Chicago. The woman realized she'd been dating a man who hadn't been to the dentist in nearly 20 years and had gum disease.

Daily flossing, frequent brushing and chewing sugar-free gum, which washes away plaque and bacteria, can help. (Read more)

Summit and local groups focus attention on oral health, a big problem for Kentucky and one that can hurt overall health

By Sarah Vos and Al Cross
Kentucky Health News

When it comes to dental health, Kentucky is down in the mouth. It ranks among the worst in the nation, with high numbers of working adults who don’t have all their teeth, and a high percentage of children with untreated tooth decay.

These and other unflattering facts about the state’s dental health, and ways to change them, were part of frank discussions at the Kentucky Oral Health Summit in Lexington on Wednesday, May 11.

Part of the problem is that Kentucky doesn’t have enough dentists to serve its population, especially in rural areas. (New York Times photo by Stephen Crowley: A student awaits treatment at First Kids Dental in Barbourville.)

“We don’t have enough dentists to fight basic disease,” said Julie McKee, dental director for the state Department of Public Health.

For those who rely on Medicaid, including more than 460,000 Kentucky children, dentists are even harder to find. Only 25 percent of dentists in the state regularly take Medicaid patients, McKee said.

Another part of the problem is a basic lack of understanding about oral health and its role in overall health, several participants said.

Research has shown that gum disease and cavities are closely related to other health issues and that a healthy mouth is key to a healthy body. Diabetes, heart disease, and premature birth are all associated with poor oral health. In children, poor oral health can affect school performance.

“Healthy teeth don’t hurt,” McKee said. “Sick teeth hurt. People with sick teeth can’t learn.”

In some parts of Kentucky, local and regional oral health coalitions are working to raise awareness about the problem and encourage people to get dental care. They face many obstacles.

A large number of Kentuckians don’t have dental insurance, and dental bills paid with private funds can be expensive. Inside the dental profession, there are turf battles between dentists, dental assistants and dental hygenists.

The Oral Health Summit attracted dozens of representatives from county and school oral-health programs and public-health clinics, and some dentists. However, no one from the Kentucky Dental Association, which represents practicing dentists, attended the conference.

Mike Porter, the association's director, said that the group's leaders could not attend because they were all in Washington at a national leadership conference. Porter said that the KDA was "totally committed" to improving the state's oral health. "It was just a logistics issue," he said.

To increase the number of kids getting preventive care, mobile units visit schools to examine and treat children during the school day. But these efforts are sometimes opposed by dentists who worry that the competition will hurt their businesses.

“The dentists are concerned these mobile units are going to come in and take their clientele,” Teresa Morehead, a Lawrence County school nurse, said in an interview. “Right now, they’re not anybody’s clientele.”

School-based programs are also hindered by the fact that many parents don’t understand the importance of baby teeth to long-term oral health. Parents think that because baby teeth fall out, it doesn’t matter if a child gets a cavity, McKee said, but baby teeth hold spaces for the adult teeth, allow children to eat a variety of foods, are used for speech, and affect children’s self-esteem.

“They don’t understand the importance of needing that follow-up,” said Felicia Elliott, a nurse and health specialist for the Audubon Area Head Start in Western Kentucky. “They don’t understand how it will affect their future life.”

But these workers on the front lines of children’s health often have trouble finding a dentist who will take new Medicaid patients, or ones who will see patients who can’t afford to pay.

Stacy Trowbridge, who runs the Barren River District Health Department’s dental services, said she often sees children with severe problems who need more care than she can give in the mobile clinic. One boy, for example, had 17 cavities and was in the nurses’ office every day because of tooth pain. But Trowbridge couldn’t find a dentist who would take him, and his parents couldn’t afford to pay for the care on their own.

“We don’t know where to send them,” Trowbridge said.

Another barrier to improving oral health in Kentucky is that many nurses and doctors have not been taught to look inside patients’ mouths, visually examine their teeth and identify problems.

“If you’re not trained, you’re not comfortable,” McKee said. She that is part of the “headless horseman of health care,” which also includes the limited extent of insurance for dental and mental health services and eye care.

The conference attendees, who were working on the state’s strategic plan for oral health, identified several things Kentucky could do to improve its oral health. These included expanding the services dental hygenists can provide, educating communities and legislators about the importance of oral health, and getting high-profile figures such as athletes to promote good oral health.

The goal, McKee said, is to change attitudes and help Kentucky’s citizens, businesses, and policy makers see the value of oral health and realize that their teeth, baby or adult, are worth keeping healthy.

“Oral health,” she said, “is everybody’s business.”

Shingles vaccine available, but expensive, and can be hard to find

Though it's expensive and can be hard to find, a vaccine against shingles is now available to people 60 and up, and in some cases to those 50 and up. Until this year, the vaccine, approved by the U.S. Food and Drug Administration in 2006, was only available to people 60 and older, The Courier-Journal's Darla Carter reports.

The painful, contagious rash, which is caused by a reactivation of the chickenpox virus, affects about 1 million Americans each year. It usually appears on one side of the face or body and results in blisters, fever and pain. It can also result in permanent pain, a condition called post-herpetic neuralgia or PHN.

Though the FDA had approved the vaccine, "Some medical facilities are waiting until action by the U.S. Centers for Disease Control and Prevention before agreeing to provide the vaccine to people 50 to 59. The topic is expected to be discussed at the June meeting of the Advisory Committee on Immunization Practices, which makes vaccine recommendations to the CDC," Carter reports.

The vaccine can cost more than $200, must be frozen and isn't always covered by insurance or Medicare. It is only covered through Medicare Part D, but not Medicare Part B. Many insurance companies are deciding whether or not to cover the vaccine pending the advisory committee's decision.

At Kroger pharmacies, the vaccine is available without a prescription for people 60 and up, but younger patients need a prescription, Carter reports. Take Care Clinics and Walgreens pharmacies require that customers be 60 or older to receive the vaccine. (Read more)

Kicking smoking habit not that hard, Philip Morris CEO says

The CEO of cigarette giant Philip Morris International said kicking the smoking habit isn't that tough, though he acknowledged that cigarettes are bad for one's health and are addictive.

Louis C. Camilleri's comment was made to nurse Elisabeth Gundersen of the University of California- San Francisco, one of many members of anti-tobacco groups who attended Philip Morris' shareholder meeting in New York Wednesday. She said one of her patients told her last week "that of all the additions he's beaten — crack, cocaine, meth — cigarettes have been the most difficult," reports Michael Felberbaum of The Associated Press.

Camilleri, right, responded, "We take our responsibility very seriously, and I don't think we get enough recognition for the efforts we make to ensure that there is effective worldwide regulation of a product that is harmful and that is addictive. Nevertheless, whilst it is addictive, it is not that hard to quit. . . .  There are more previous smokers in America today than current smokers." Camilleri is a longtime smoker.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called Camilleri's comments the "most irresponsible form of corporate double-speak."

Worldwide, there are 1 billion tobacco users, according to the World Health Organization. The U.S. Public Health Service has said about 45 percent of American smokers try to quit every year, but only 4 to 7 percent are successful. About 25 percent of Kentucky adults smoke, the highest percentage nationwide, according to Kentucky Public Health Commissioner Dr. William Hacker. (Read more)

Prescription pill problem in Kentucky, elsewhere under microscope on NPR program

The growing prescription-drug abuse problem in Kentucky and other states was under the microscope Thursday during National Public Radio's "On Point," hosted by Tom Ashbrook.

The Courier-Journal's Laura Ungar, who wrote an extensive series on pain-medicine abuse this year, was one of three journalists who spoke about the epidemic. Dealers visit various pain-management clinics, which have been labeled "pill mills," fill the prescriptions and then sell the drugs at a high profit.

Ungar, left, called the prescription drug trade "akin to the illegal drug trade, where many of our folks in Kentucky are getting drugs that originated in Florida." Indeed, 98 of the nation's top 100 prescribers of drugs Oxycontin and Xanax are in Florida, the journalists conveyed.

One caller to the show, identified as Michelle of Carter County, Kentucky, shared what it was like when her mother was a pain-meds addict. "We would wake up in middle night and have to put her to bed because she was like a zombie," she said. "It was like no one was there."To read more and listen to the show, click here.

Construction, expansion at UK HealthCare boosting Lexington's economy; total payroll now exceeds 8,700

The construction and expansion at UK HealthCare, which comprises the University of Kentucky's College of Medicine and Albert B. Chandler Hospital, is giving Lexington a fiscal boost in an otherwise difficult economy. More than 8,700 people now work at the hospital and medical school.

The school's number of employees has grown by 900 since 2004, topping out at 3,989, reports Margaret Buranen of Business Lexington. In the same period, the number of full-time hospital employees grew from 2,562 to 4,722, an 84 percent jump. The payroll, including salary and benefits, has risen to $677 million, about $300 million more than in 2004.

Another notable change in the past seven years is the ratio of full- and part-time faculty members at the College of Medicine. "The number of part-time faculty members has decreased nearly one-third, while full-time basic science and clinical faculty members have both increased. The net result is a 21 percent increase in faculty members," Buranen reports.

Construction of the new Chandler Hospital has produced a payroll of $72 million in the private construction sector, which translates to 300 full-time jobs during construction. In addition, the fact that UK HealthCare used Kentucky vendors for building materials and supplies whenever possible results in an economic impact of $88.6 million., Buranen reports.

Phase I of the hospital construction includes a parking structure, trauma center and emergency department, which opened in July 2010. The hospital pavilion, which includes two floors of patient rooms, opens May 22 and will be dedicated Sunday. Phase II will cost $230 to $250 million. (Read more)

State health commissioner encourages smoke-free ordinances

Kentucky's public health commissioner said communities are moving in the right direction by enacting smoke-free ordinances and hopes Kentucky can become a smoke-free state. "We have communities in Letcher County, as well as areas in far Eastern Kentucky, Western Kentucky and Northern Kentucky implementing second-hand smoke ordinances because it's dangerous for people who are non-smokers," Dr. William Hacker said.

Hacker, who spoke at the Breathing Clean Air Summit in Owensboro Thursday, said 25 percent of Kentuckians smoke, the highest percentage in the country, reports Jasmin Embers of WFIE-TV in Evansville. "We're ranked number one in lung cancer deaths, so if you're number one in smoking, you can expect to be number one in lung cancer deaths," Hacker said.

Hacker encouraged communities that already have smoke-free efforts or laws to go farther. Change can be seen at Owensboro Medical Health System, which now has four smoking huts on its campus. Those will be eliminated by the end of the year, a move that was decided after employees responded to a smoking survey. "Half of the respondents said they felt that smoking on OMHS grounds contradicted our mission statement to heal the sick and improve health of our community," wellness committee member Gordon Wilkeron said. (Read more)

Fort Campbell using simulated battlefields to assess brain injuries

Doctors at Fort Campbell are using a mock battlefield to assess whether or not soldiers who have suffered a traumatic brain injury are ready to return to combat. The clinic has been recognized by the Department of Defense as a national model.

"Soldiers are making life and death decisions, so doesn't it make sense to use demonstrated competence as the standard for returning someone to duty?" Dr. David Twillie told National Public Radio's Blake Farmer.

In exercises meant to simulate scenarios they face when fighting in Iraq and Afghanistan, soldiers sweep a gravel road for possible roadside bombs, take fire from insurgents and are told to insert chest tubes and tie tourniquets while listening to sound from a scene in Saving Private Ryan. The goal is to assess how well the soldiers handle the stress of the situations. Patients must also take written tests that assess their competence. The combination of both simulated and written assessments is important.

"Very recently we had a soldier that had a desire to stay in, had done well in all our simulations," Twillie said. "But when all the different sights, sounds, smells came back, he just wasn't able to change his focus, and that's very important in combat."

Memory loss, mood swings and difficulties balancing are common symptoms of a traumatic brain injury. About 115,000 soldiers have experienced such an injury, the Defense Department estimates. (Read more)